Wednesday, June 18, 2008

How Does It Happen?

Imagine for a moment, you're a parent - of an adorable 3-year old girl. Since birth she's thrived and is quite the little social butterfly now that she's getting older. She eats well, plays hard and is just a delight. Your last visit to the pediatrician, when she was 3-years 8-months old, went great - with all the alarms about childhood obesity, you were pleased the doctor was so proactive to weigh and measure her, even more happy when he declared she was a healthy weight and doing great!

Fast forward a couple of months, today your little girl has what seems to be a cold that's progressing, so you make an appointment and the doctor's office squeezes you in.

When you arrive, the nurse takes you into the exam room, weighs and measures your daughter (just like last time) and takes her temperature. She asks you to wait a few minutes, the doctor will be in soon.

A short time passes and the doctor comes in, examines your daughter and doesn't think it's something that needs antibiotics and explains how to monitor her fever and keep her hydrated. He then says, we need to talk about her weight, her BMI places her in the 85th percentile, which puts her at risk for overweight.

I wouldn't worry too much. Kids go from Buddha-like to sylph-like and back again over their childhoods. Over the summer, feed her lots of fruits and vegetables and give her plenty of opportunities to play outside. I bet she'll be on track by fall.

If her weight's still a cause for concern, look at her carbohydrate consumption and cut back on the high-glycemic ones, which might be driving her hunger. Unless her diet's really out of whack, don't cut back on her fats - kids need them.

The doctor didn't say the kid is overweight, just that she's at risk for becoming overweight! I'm going to guess that what's happened is that the doctor got some kind of directive from the HMO to monitor kids' BMI. BMI's a flawed measure for adults and, I would guess, even more so for toddlers.

85th percentile means nothing for growing children (they grow in spurts to their own pattern, maturity, genetics, etc.) and no doctor in their right mind would react or do anything; let's see what happens as she grows and how she follows her individual growth curve.

The doctor didn't say the kid is overweight, just that she's at risk for becoming overweight!

It really depends on which source you use for information - there is a huge debate if "at risk for overweight" needs to be replaced with the less politically correct "overweight" since the consensus is that 85th percentile through 95th is overweight and 95th and higher is obese, but few desire calling a child "obese" and we're in this murk....is 85th "at risk" for overweight, or do we call it what we really mean, simply "overweight"?

If that is the child in the picture one can clearly see she is grossly overweight. (and I am totally exagerating here) what a load of absolute tripe if that kid is obese or on the way to being so then I must be the easter bunny & I know I'm not the easter bunny. More fooling around with figures (obviously the BMI figures have been lowered yet again along with blood pressure & cholesterol figures - talk about salemen drumming up business) to put people into categories makes you want to scream doesn't it?